There are different types of stroke. Ischemic strokes, which account for 85 percent of strokes, are caused by a blockage to a blood vessel supplying blood to the brain. Hemorrhagic strokes happen when a weakened blood vessel ruptures and bleeds into surrounding brain tissue.

Either way, the end result of stroke, also known as a brain attack, is the same: Brain tissue dies, resulting in neurological impairment.

Stroke, despite representing the third leading cause of death and leading cause of long-term disability, remains less well known than other major killers like heart attacks and cancer. But Washington Hospital's Stroke Program is working to change that through a free monthly Stroke Education Series.

On Tuesday, Nov. 3, Washington Hospital will host a seminar focusing on educating community members about stroke and its risk factors.

To lower your risk, learn about stroke

Dr. Ash Jain, Medical Director of the Stroke Program, says lack of awareness about stroke is common - and dangerous.

"Often people don't know about strokes at all; their knowledge is near zero," Dr. Jain says. "Most of the audience during the education series is made up of stroke victims or family members, but if members of the community have risk factors, then they are at risk for stroke and they should know about it."

The good news, he says, is that treatment continues to evolve.

"Management of stroke has become more aggressive and results are improving on daily basis," Dr. Jain says. "Treatment has changed over last few years, and patients have an important role to play since they must seek care early on in order for management to be effective. The earlier they seek help, the better the outcomes.

"There is a window of up to eight hours that you can successfully manage strokes, though in most of the hospitals the window is up to four and half hours. Beyond four and a half hours, you have to go into the brain and that requires specialized expertise and equipment that we employ in the Stroke Program."

"Stroke is the most disabling disease out there," he says. "Life after stroke is terrible, so if we can prevent it, that is the ideal outcome. If a member of the community does have a stroke, we want them to get to the hospital as fast as possible."

Among the risk factors that Dr. Jain will discuss are:* High blood pressure* Diabetes* High cholesterol* Blockages in the neck arteries* Irregular heart beat

For those that have already had a stroke, managing risk factors is doubly important because having a stroke greatly increasing the chances of subsequent strokes, Dr. Jain emphasizes.

"Members of the community need to know what stroke is, understand its symptoms, know how to prevent it," Dr. Jain says. "Most importantly, they need to know to seek help as soon as possible by calling 9-1-1."

Fighting stroke with education

Ask Doug Van Houten, R.N., Coordinator of Washington Hospital's Stroke Program, what the biggest risk factor is for stroke, and he might say: Not knowing about it.

"The prevalence of stroke is increasing and is now about 795,000 people each year that are experiencing new or recurring stroke," he says. "The bottom line is: If you don't know about risk factors and signs and symptoms of stroke, then you're destined to have a poor outcome."

For that reason, the best means of prevention is making sure to understand your own personal risk for stroke, Van Houten says, as well as being aware of stroke signs and symptoms.

Citing a 2005 survey by the Centers for Disease Control and Prevention's

Behavioral Risk Factors Surveillances System (BRFSS), Van Houten points out that only 38.1 percent of respondents in 14 states were aware of the five warning signs of stroke and said they would call 9-1-1 if they thought someone was having a heart attack or stroke.

Van Houten says one of the problems is that stroke has very few warnings signs comparatively with other disease processes and also less visibility in the public eye compared to cancer, diabetes and heart attack.

"If you have asthma, you know how it feels to be short of breath," Van Houten says. "If someone has a heart attack, many times they will experience angina before the attack. Typically if you have cancer, you notice rapid weight loss. But stroke is a silent killer. Ninety-five percent of the time you simply experience neurological dysfunction with stroke, not pain.

"As a result, people do exactly the wrong thing - they go lie down and take a nap. And when they get up, the stroke is absolutely completed and they're outside the window for effective treatment."

Don't be a victim - Learn if you are at risk

Now is the time to learn if you might be at risk for stroke. Join Dr. Ash Jain and Doug Van Houten for their upcoming seminar, "Introduction-Stroke/Risk Factors for Stroke" on Tuesday, Nov. 3, from 6 to 8 p.m., in the Conrad E. Anderson, M.D. Auditorium.